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Steve – please share with Mac how ACT has worked for you. You have had sleep maintenance issues like Mac, unlike me, who has had sleep onset insomnia and couldn’t fall asleep in the first place. Mac thinks he has no sleep anxiety because he has no problem falling asleep when he goes to bed. But it must be there because it’s waking him up too early and then won’t let him fall back asleep. I think for you it was the same. Through ACT your sleep started lengthening instead of waking you up so early and it also became easier for you to fall back to sleep when you did wake up. Am I right?
Karen – sorry you had a bad night. I know it’s very frustrating. But you recovered from your last relapse so you will again this time.
Mac – I agree with what Steve and Karen have said. Like Karen said, you want to have a flexible sleep window. Of course you don’t want it to be so flexible and wide open that you’re not tired at all, but with ACT, you don’t need to have a tight sleep window. Mac – you want to get back to the place where you were before the insomnia, when you didn’t have to worry about sleep drive and whether or not you’re tired enough. You just went to bed at the usual time, with the usual amount of tiredness and then fell asleep. That’s because you were completely relaxed about sleep. This is what ACT will do for you.
I think there’s still a lot of anxiety there underneath the surface and that’s why things continue to flare up for you. I agree with Steve that you really need to read the sleep book again so that you understand it more deeply. I’ve found that many times I go back to a book I’ve read before and find so many new things in there that I didn’t appreciate before and completely went over my head. I know that both Karen, Steve and Gdsmom have mentioned going back to the book to get help. Last night that’s what happened to me. I was so frustrated and tempted to take a sleeping pill, and then the page I opened to talked about how when you’re really tired your motivation and willingness to experience discomfort is lowered. That was me alright! The rest of that page was very relevant to me as well (pg 77).
Mac – I know that there is a place for SRT, but it seems to me that it’s possible that at this point for you it’s become a crutch. Because it helped you sleep in the past, you automatically think that’s what you need to do in order to sleep. But you know through experience that you’ve gone back to it over and over again and still did not get the results you wanted. It’s time to do something new. Stop worrying about your sleep window and give yourself enough time to get the rest that you need. And then if you wake up, practice ACT – accept whatever happens and over time you’ll start falling back to sleep more easily. I think that’s how it’s been for Steve. Steve – am I correct?
Sorry you’re having such a hard time, Mac. I was wondering, what if you were to move up your bed time? For myself, my recovery was helped by not having to worry about waking up early and not getting enough sleep. So for instance, what if you were to move your bed time to 9:00? Then even if you woke up early before your alarm clock, you still would get plenty of rest. Then when you went to bed you might have less alarm clock worry. Just a thought.
Last night my sleep was much better. But I’m still not completely confident. I went to bed totally exhausted after two days of being pretty tired, but then worry kicked in. I knew I wasn’t going to fall asleep that way so I got up. I knew I had to do something to calm myself down. I was feeling very frustrated though and tempted to say “the heck with it” and take a sleeping pill. I decided to compromise and had a drink and journaled for a bit. It helped a little but still my mind was not in the right place. Finally I got the inspiration to read a little from The Sleep Book. I opened it up to a random page and read. It was exactly what I needed to read and calmed me right down. Then I went to bed, fell asleep and had a good rest. Thank goodness.
Yes I had one relapse before in October. It took me awhile because like, Karen, I wasn’t very happy with the relapse after sleeping great for 2 months. I was in denial at first, drinking my white russians to knock me out and then I traveled 2 times and when I did I took Ambien. I think I was also afraid that it might not work as well as it did before and part of me was afraid to try. But once I buckled down and did ACT again, I was good to go by about the third night. Glad you’re sleeping well again, Karen.
I make my white Russians with equal parts vodka, Kailua and half & half. It’s about one ounce each for a total of 3 ounces.
David (Da) – our type of insomnia is caused by sleep anxiety, so we need therapy specifically for this. That’s what CBT-I and ACT are for. You can try all these different supplements and eat healthier, but this might not make much of a difference to your sleep. The anxiety was brought on and perpetuated not by something physical, but mental.
You mention how you “try to fall asleep” when you go back to bed. This is the problem. The more you “try” (including supplements, etc.) the more sleep will elude you. You have to let go of trying and struggling to go to sleep. That’s the main message of the book.
I was awake most of the night but I stayed in bed not trying to do anything about it like getting up and having a drink or pill and reading. Luckily I got some sleep in the early morning so I’m not a zombie today. I’m sure it will hit hard in the evening though. I want to stay on schedule, so even if I’m tired I’ll stay up till at least 10:30 or so.
This has been my pattern before, so hopefully tonight it will start improving. Just do nothing and let go and eventually the body will take over again. Just do what a normal sleeper does.
Ok, thanks for the clarification. Most everyone here on this forum has the anxiety perpetuated insomnia, that’s why I thought you might too. I hope you can find the cause and solution to your shallow sleep.
I’m hoping so, Mac. It worked last time.
Lauriso – if you’re interested in finding out about ACT, the best resource is reading The Sleep Book by Dr. Guy Meadows. The focus is on reducing any anxiety about sleep (either consciously or unconsciously) so that your brain settles down and you can sleep normally again. He also has a website you can check out with a brief introduction to it.
Thanks, Steve. Sounds like overall you’re getting better. I’m lucky that I don’t have to worry about getting up early. This has helped me a lot and has removed that element of anxiety. I’m able to go to bed and just sleep as long as I need to sleep, which is usually until 7:30.
Lauriso – have you been checked out already for sleep apnea? A friend of mine was not sleeping well for months and finally found he has sleep apnea. Now he uses the mask and is sleeping much better.
Steve – I’m still taking the minimum dosage of Effexor, but not for sleep. Just want to keep a upbeat attitude about some other things going on in my life right now.
I had a couple rough nights. This sleep thing is so delicate and it’s so easy to get out of whack! The night before last I was too warm and somehow that kept me awake for a long time. Finally I looked at the clock and was surprised to see that it was 3:00! So I got up, had a white Russian and read for about 45 minutes. Then I was just about to go back to bed when I decided to take an Ambien to make sure I slept. Not a good idea, but oh well. I slept about 4 hours and woke up groggy but was fine all day. But this set me up for a difficult night last night. I had lost confidence in my ability to sleep without any props by having the drink and the sleeping pill. So last night again I laid in bed for a long time even though I was tired. Finally I got up after 2 hours, had a drink, read about 30 minutes and went back to bed. Fell asleep right away but then woke up too early and couldn’t fall back asleep. I’m tired today.
So tonight I need to go cold turkey again to get out of this cycle. No drinks, no pills, no getting up – just stay in bed. It might be a long night, but that’s ok, because this is what get’s me back on track and reminds my brain that I can sleep without any crutches. Then I start sleeping like a normal person again.
Hi Lauriso – welcome to the forum! I had a few therapy sessions with Dr. Kat from The Sleep School and she explained this to me. She’s a sleep doctor and said that she used to do primarily research on sleep before she got into doing insomnia therapy. She said that they did research comparing the brains of people with insomnia with the brains of normal sleepers, while they were sleeping. For people with insomnia, the amygdala, which is the emotional center and controls the fight or flight response, is much more active than that in normal people. So it’s on high alert all the time, waiting for any signs of danger, even while we’re asleep. That’s why for insomniacs our sleep can be shallow or we wake up very easily. It’s sort of like trying to sleep in a war zone. The brain can’t completely relax when it thinks that danger might be right around the corner. That’s why ACT therapy is good for insomnia because it helps to calm down the brain.
How long have you had insomnia and which kind do you have? Sleep onset, sleep maintenance or both? I had sleep onset, many times taking hours before falling asleep. When I finally started to fall asleep consistently through practicing ACT, my sleep was very shallow with lots of dreams or being in and out of sleep all night. I worried about the shallow sleep so that’s why I contacted Dr. Kat. She reassured me that this was normal. Over time my sleep consolidated and lengthened and now I have recovered from insomnia.
David – just want to let you know that I’m sleeping normally now and not afraid of doing things that I did before the insomnia (although being a grandma now, I’m not big into staying up late drinking & partying!) So you can heal completely from this. ACT helps you learn to relax and let go of anxiety over sleep, which in turn helps you to fall asleep. I still have a little anxiety now and then, but when I do I just remind myself to not worry about it and then I fall asleep. But it takes awhile to get to the point where our anxiety has decreased a lot. ACT will help you do that.
I think that this is probably the best book out there on CBT-I: End the Insomnia Struggle by Colleen Ehrnstrom and Alisha Brosse. These are two psychologists who specialize in this area. They explain the two behavioral strategies of SR, restricting your time in bed, and SC, getting up when you can’t sleep. Also they explain different cognitive (thinking) strategies including mindfulness as well as others.
When I was doing my research I went to the library and got out 4 books on sleep. Of all 4 there were only 2 that mentioned CBT-I. One book had 1 page in the Appendix on it – that’s it! The other had 5 pages total (out of 200 or more) on SC. That’s all I found. The most recent book of the 4 had nothing on it. So it seems a lot of sleep doctors know nothing about about CBT-I or ACT and have no answers for those of us suffering from chronic insomnia, which in my opinion is the WORST kind of insomnia to have! By the way, it was reading the 5 pages on SC that led me to look up stimulus control on the internet and find Martin’s website.
